July 9, 2009

Under The Knife

Rewind and Review

by Will Carroll

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Vlad Guerrero (10 DXL)
Torii Hunter (TBA)
Kelvim Escobar (110 DXL)
I often say two contradictory things, so I need to explain how they actually work in concert. The operative phrases here are "don't believe your eyes" and "what you see guides us." Both statements are true, but you have to use both to understand what's going on with Vladimir Guerreo. The video showed him making a long stride as part of his throw in from the outfield, then immediately collapsing, leaving him on one knee and grabbing behind it. The "collapsing" part is a bit strong; he goes to the knee more than collapses, but I understand why that word would be used. He is grabbing behind the knee, but it's the calf, not the knee itself, which creates another confusing point. I've looked at the video several times, and you can see him push forward as he grabs, as if he's trying to stretch a cramp. So having seen all that, we have to forget it and trust the information we get from his MRI. Early indications are that he's dealing with a moderate strain at the top of his calf. Guerrero may head to the DL or be forced back to DH for a while, though he'd expose the leg to further problems. Joining Guerrero in the training room and the MRI tube was Hunter; the rangy center fielder says he has been dealing with a chronic groin strain for a month. The pain has gotten more significant, and the MRI was done both to see how significant the strain is, its precise location, and to rule out the dreaded acetabular labrum issue we've seen several times this year. Finally, the Angels are finally admitting that Escobar is likely done for the year. As I've said since the pre-season, Escobar's comeback was a long shot, and it says something about him that he was able to come back at all.

Hanley Ramirez (7 DXL)
The Marlins insist that Ramirez will play before the All-Star break, but I'm not sure why they feel so strongly about it. They're 2-2 in the four games that Ramirez has missed, have adequate replacements available with or without using the DL, and they have a key series with the Phillies just after the break. Ramirez's Grade I strain of his hip flexor is on that edge that makes it tough for a medical staff; do they use the DL, or will he be ready to play and stay healthy just before that length of time? Team sources tell me that they'll avoid the DL at almost all costs due to that Phillies series, hoping that the time off plus the break is enough. If so, then keeping him out against the D'backs seems the smart play, though Fredi Gonzalez seems to think that Ramirez will play a couple games there. If one of them is a test, I can grasp the thinking, but the Fish are playing a dangerous game here with their star.

Alex Gordon (80 DXL)
Mike Aviles (120 DXL)
Royals fans deserve some good news, and maybe there is some on the injury front. Here it is: Gordon is playing in Double-A and showing no problems with the hip. The management of his hip problem, done from Vail, seems to have Gordon on precisely the track and time we'd expected from the start, and essentially on the same timetable as Alex Rodriguez was on. I'd expect similar results, assuming that the Royals stick to the rest patterns likely to be prescribed. Gordon should be back after the All-Star break. In other news, Aviles had his Tommy John surgery, but expects to be back for spring training. That's just eight months from now, but Aviles isn't a pitcher; for pitchers, the one-year mark is the standard return, but for position players who don't put as much strain on the arm, they can return much more quickly. There's a difference between the repetitive stress of 100 pitches in a start and that which comes from an off-balance throw made from deep in the hole, so there is some danger with a quick comeback, but this wouldn't be unprecedented.

Kyle Lohse (40 DXL)
Lohse had a solid rehab start in Memphis, throwing 95 pitches over six innings. There were no problems with his forearm, or with much of anything, giving the Cardinals no reason to think that he won't be back and effective in short order. He's expected to be one of the pitchers in Sunday's doubleheader with the Cubs, so he's being thrown right back into the heat of the race. Lohse's forearm injury is tough to judge because it was so odd, the seeming result of a traumatic contusion more than a normal pitching injury. Assuming there was no damage done by trying to pitch through it-and the results in rehab look good-Lohse shouldn't have further issues, though I'd suggest again that there's a lot more we could do to protect pitchers.

Geovany Soto (5 DXL)
The first comment yesterday asking me about Soto came twelve minutes after Soto's injury, an apparent oblique strain. In that twelve minutes, Soto had been examined by the team's trainers, walked back to the training room, and as best I can tell was lying on his side with ice on his injury when I was asked what was wrong. I'm a reporter, not Miss Cleo, people. At this stage, I have neither contacts with info on this or context for what happened, the two things I rely on to do what I do. Soto injured himself on a normal batting-practice swing, and seemed to respond well afterwards. The mild strain will keep him out for a couple games, and with the All-Star break coming up, the Cubs might elect to let him rest through it with Koyie Hill handling most of the catching, with Jake Fox in reserve.

Scott Downs (20 DXL)
B.J. Ryan (0 DXL)
The Jays brought Downs off of the DL and threw him back into the closer's role. It's not as if this is surprising, but some of the rust showed in his initial appearance. Downs didn't blame the toe, which doesn't appear to be an issue, though he is continuing to get treatment on an injury that seems to be classic turf toe. That can linger, though admittedly there's not much experience with pitchers who have suffered this particular injury. Going forward, Downs won't have Ryan handing the ball to him after Ryan was released by the Jays; without his velocity, Ryan became nothing more than a very expensive LOOGY. At a minimum salary with a change of scenery, Ryan becomes an interesting option for that role; teams like the Marlins, Rays, and Angels could be suitors.

Alfredo Amezaga (100 DXL)
Mets fans, meet Alfredo Amezaga. You might know him from a few meetings with the Marlins. If you wonder why I'm introducing you, it's because Amezaga is going to be very important to the Mets' hopes in 2010. He won't play for them, but he will be having microfracture surgery soon, as he'll be heading to Vail to have the procedure, the same type that Carlos Beltran may need in the near future. Since there aren't many examples to draw from, Amezaga will be something of a crash-test dummy for Beltran, and Amezaga's subsequent rehabilitation will be one that a lot of people keep their eyes on for guidance. While Amezaga and Beltran don't have a body type in common, it's close enough to get some more idea on what the Mets might be headed for.

Quick Cuts: Jed Lowrie was optioned to Pawtucket to continue his rehabbing; he'd run out of time on the 20-day clock, but should be back soon. ... If you're expecting Edinson Volquez back before mid-August, stop. ... I have no idea if Oliver Perez was affected by his knee on Wednesday night. How can you tell with him? ... David Bush will make the first of two minor league starts on Friday as he gets ready to return to the Brewers rotation. ... Kelly Johnson went 0-3 in a rehab outing at Triple-A, and looks to be ready to return after the All-Star break ... Jose Molina was activated and goes right back to his normal backup slot; we'll see if Joe Girardi continues to pair catchers with pitchers. ... Rafael Betancourt's groin has healed up, and the Indians have activated him before today's game ... Emmanuel Burriss is done for the year after surgery to fixate his broken foot, an injury he'd suffered in the minors after his demotion. ... In one take on Manny's situation, here's one from Mike Celizic with which I completely agree. ... On the other hand, I completely disagree with John Fahey's position, though I respect it. When I testified before a WADA committee in 2005, Fahey was one of the more level-headed people I met on what proved to be a very curious day. ... Matt Chico is on schedule in his return from Tommy John surgery, despite an odd activate-and-option move necessitated by roster rules. ... Carlos Guillen will head out on a rehab assignment this weekend and could be back quickly.